Pharm Opioids- Nagelhout Questions And
Answers Graded A+ 2024/25.
What are the 3 naturally occurring phenanthrenes? - correct answer. 1) Morphine --
> HISTAMINE
2) Codeine ---> HISTAMINE
3) Thebaine
What are the 5 semisynthetic phenanthrenes? - correct answer. 1) heroin
2) vicodin (Hydrocodone)
3) dialudid (hydromorphone)
4) oxycodone (oxycontin)
5) oxymorphone
What are the 7 synthetic phenanthrenes? - correct answer. 1) levorphanol
2) butorphanol
3) nalbuphine
4) pentazocine
5) naloxone
6) naltrexone
7) nalmefene
What are the two mixed opioids? (synthetic phenanthrenes) - correct answer. 1)
nalbuphine - can antagonize respiratory depression and pruritus, but maintain analgesia
2) butorphanol
MU antagonists, Kappa partial agonists, and Delta agonists
What are the 6 piperidines? (all are referred to as phenylpiperidines even though this
isn't technically correct) - correct answer. 1) meperidine --> HISTAMINE
2) loperamide
3) Fentanyl
4) Sufentanil
5) Alfentanil
6) Remifentanil
What is the only diphenylheptane? - correct answer. methadone
, Which are the 3 specific drugs that are MOST likely to stimulate histamine release? -
correct answer. 1) codeine
2) morphine
3) meperidine
-general rule = phenanthrines and demerol
Are there cross allergies between classes? - correct answer. NO
-just AMONG classes
1) If someone is allergic to Vicodin can they have oxycodone?
2) If someone is allergic to morphine can they have dilaudid?
3) If someone is allergic to codeine can they have demerol?
4) If someone is allergic to fentanyl can they have morphine? - correct answer. 1)
NO
2) NO
3) YES
4) YES
Why do opioids cause analgesia? - correct answer. -suppress release of pain
chemicals
-PRESYNAPTIC AGONISTS THAT CAUSE INHIBITION OF RELEASE OF
SUBSTANCE P and other neurotransmitters
What class includes the drugs of choice for asthmatics? - correct answer. -
phenylpiperidines EXCEPT demerol
-ex: FENTANYL is safe
Opioid with equal potency to fentanyl - correct answer. remifentanil
Opioid with weakest potency - correct answer. codeine
Opioid with strongest potency - correct answer. Sufentanil (MU agonist)
What are the 4 endogenous opioid peptides? - correct answer. 1) enkephalins
2) B-endorphins
3) Dynorphins
4) Endomorphins
What is the MAIN receptor that causes analgesia? - correct answer. -MU
-if all do the action write MU because it is the MAIN one
What endogenous receptor causes dysphoria AND sedation? - correct answer. -
Kappa
-also think SHIVERING for kappa
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